A dominant healthcare practice for many Mexican-Americans is the hot and cold theory of food selection, where illness or trauma may require adjustments in the hot and cold balance of foods to restore body equilibrium. In lower socioeconomic groups is a wide-scale deficiency of vitamin a and iron, as well as lactose intolerance.
Mexican-American birth rates are 3.45 per household compared to 2.6 per household among other minority groups (Chapa & Valencia, 1993 as cited in Purnell & Paulanka, 1998). Multiple births are common, particularly in the economically disadvantaged groups. Men see a larger number of children as evidence of their virility. If a woman does not conceive by the age of 24, it may be considered too late. Given their predominant Catholic beliefs, the tendency is only to use acceptable forms of birth control, although many will use other unacceptable forms. Abortion is morally wrong. Family planning is an important area, where healthcare providers can identify more realistic outcomes that are consistent with current economic resources and family goals. Since pregnancy is deemed natural and desirable, many women do not seek prenatal evaluations nor do many know that prenatal care is so essential. Healthcare providers need to encourage female relatives and husbands to accompany the pregnant woman for health screening and incorporate advice from family members into health teaching and preventative care services.
Mexican-Americans often face death stoically as a natural part of life (Purnell & Paulanka, 1998), and death practices are an adaptation of their religious views. Once again, family is very much involved with the event, spending time with the dying person and gathering together for a "velorio," a festive watch over the body before burial. Some Mexican-Americans bury the body within 24 hours, which is required by law in Mexico. Autopsy is acceptable as long as the body is treated with respect, cremation is an individual choice. Although Catholicism is the primary religion, other religions are followed as in Selena (Nava, 1997), who was a Jehovah Witness. Indian practices can also be incorporated into some beliefs. Some Mexican-Americans continue to follow the practice of having two marriage ceremonies, particularly in poorer areas. First a civil ceremony is performed; later, when enough money is saved, a celebration is held at a church.
The family is viewed as the most credible source for health information and, sometimes, the greatest impediment for healthcare providers. Because expressions of negative feelings are considered impolite, a Mexican-American may be reluctant to express health problems. Good health means feeling free of pain, and the hospital may be seen as a place to die. The healthcare provider is viewed as the last resort. Mexican-Americans of all socio-economic levels are less likely to have medical checkups. Since they promote self-care, over-the-counter medicine may pose a safety problem. Mexican-Americans may also participate in folk medicine, thus it is important for healthcare professionals to be cognizant of these practices and take them into consideration when providing treatments (Purnell & Paulanka, 1998). Thirty-five percent of Mexican-Americans in comparison to 10% of other Americans do not have health insurance. Physicians, nurses and other healthcare providers are frequently thought of as outsiders. It is pertinent for healthcare providers to establish a relationship on a personal level before initiating treatments, such as small talk or providing health education.
Most of the information in this present report comes from Purnell and Paulanka (1998), which is over a decade old. However, a paper by Lopez (2003) demonstrates that many of these healthcare challenges remain in the 21st century with Mexican-Americans, including lack of access to affordable health care and health insurance, as well as continued lack of health research by healthcare providers on the Mexican-American community. Lopez concludes that it is crucial to continue research on Mexican-American health patterns, since a variety of health problems still affect them, such as unhealthy diets, language and cultural barriers in treatment and chronic medical conditions going undiagnosed, unstudied and untreated. "With Mexican-Americans continuing to grow demographically in the State of California and other parts of the United States, these problems affect not only the Mexican-American community, but the nation as a whole. We can continue to follow these ineffective historical paths or begin to provide new insights into the health care problems and solutions for the Mexican-American community" ( p. 2).